Streamlined Poststroke Treatment Order Sets During the SARS-CoV-2 Pandemic: Simplifying While Not Compromising Care

Area of Science:

• Neurology
• Infectious Disease Epidemiology
• Healthcare Management

Background:

• Coronavirus disease 2019 (COVID-19) pandemic poses challenges to standard poststroke care protocols.
• Frequent patient assessments in stroke monitoring require repeated personal protective equipment (PPE) donning and doffing, increasing infection risk.

Purpose of the Study:

• To develop and evaluate a streamlined poststroke treatment protocol.
• To limit patient encounter frequency while maximizing care efficiency during the COVID-19 pandemic.

Main Methods:

• Development of streamlined order sets for poststroke care.
• Implementation of a modified protocol in a designated COVID-19 unit.
• Grouping various poststroke care components into single bedside visits.

Main Results:

• 70 patients with stroke admitted to a COVID-19 unit utilized the streamlined protocol.
• 47.1% of patients received acute reperfusion therapy.
• Most patients (all but 3) showed stable or improved National Institutes of Health Stroke Scale scores at 24 hours, with no deterioration attributed to monitoring.
• Neurological outcomes were favorable despite reduced patient contact frequency.

Conclusions:

• Adapting poststroke care protocols is essential during the ongoing COVID-19 pandemic.
• A streamlined approach can facilitate safe and effective poststroke monitoring for patients with unknown COVID-19 status.
• This modified protocol supports continued high-quality stroke care amidst infection risk.